Individual provider Active NPI

Nia Odlum-Thomas, MSW, LCSW-A, CTP

  • Clinical Social Worker
  • Raleigh, NC
National Provider Identifier
1962041673
Registry record updated Jul 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
P021375 Issued in NC
Practice address
3064 Wake Forest Rd # 1397
Raleigh, NC 27609-7844
Phone
(910) 502-0883
NPI assigned
Dec 27, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X P021375 NC Primary

Addresses

Primary practice location

3064 Wake Forest Rd # 1397
Raleigh, NC 27609-7844

Mailing address

3064 Wake Forest Rd # 1397
Raleigh, NC 27609-7844
Phone (910) 502-0883

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
P021375NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Authentically U Therapy & Discovery, PLLC Clinical CurrentSince Nov 3, 2024 Accepting new patients

Locations

3064 Wake Forest Rd
Raleigh, NC 27609
Phone (415) 360-3349

4454 Fayetteville Rd
Ste 2001
Raleigh, NC 27603

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1577404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784160000000",
    "number": "1962041673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3064 WAKE FOREST RD # 1397",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276097844",
            "telephone_number": "910-502-0883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3064 WAKE FOREST RD # 1397",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276097844",
            "telephone_number": "910-502-0883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODLUM-THOMAS",
        "first_name": "NIA",
        "credential": "MSW, LCSW-A, CTP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-27",
        "last_updated": "2026-07-16",
        "certification_date": "2026-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P021375",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.